County Director of Public Health, Dr Sakthi Karunanithi, has no illusions about the challenge ahead. But he believes every resident can play a part in improving the community’s wellbeing.
Statistics in a new report on public health in Lancashire have set alarm bells ringing.
The report looks at issues ranging from reducing health inequalities to promoting healthy pregnancy and reducing hospital admissions. Out of 37 markers, Lancashire was significantly worse than the English average in 23, and significantly better in seven.
It also reveals major disparities within the county with Preston, Lancaster and East Lancashire districts having much worse outcomes than Ribble Valley, South Ribble and Fylde.
Preston was significantly worse than the English average on 21 counts, while Wyre was significantly worse on eleven counts and Chorley on six counts. The data covered the period from 2012-15.
Dr Karunanithi admitted: “One of the things that is causing concern is the need to get better at (preventing) things such as obesity and diabetes, to the extent that if we don’t tackle obesity and diabetes, it could wipe out the entire NHS budget.”
Dr Karunanith said a complex mix of reasons account for Lancashire’s poor rating in the national statistics. Poverty, deprivation and socio-economic factors contribute. It’s also down to lifestyle with higher smoking, obesity and alcohol misuse and also a variation in access to and the quality of services.
He said: “If every part of Lancashire aspires to be working at a level that is the next best, we would make progress. Everyone has to up their game.”
Dr Karunanithi’s wide-ranging agenda includes taking a holistic view at the way we live and the many organisations which can enable change. Numerous agencies ranging from the NHS to local councils and other public bodies have responsibility for health and wellbeing. As our county’s population ages, cardiovascular, respiratory, alcohol-related illnesses and cancer can disproportionately impact on quality of life from our early sixties onwards.
Outlining a triple challenge in Lancashire he said: “The first is how healthily people can expect to live compared to the national averages, as well as variation within Lancashire.
“The second challenge is the quality of services people can access and get which is variable. The third challenge is the financial resources available for public services including the NHS. They are all linked.
“The three things we need to get right is to first mobilise our communities to better speak up for their health and wellbeing and mobilise our communities to improve our health and wellbeing.
“The second is to join up various services that are there for improving the health and wellbeing and, third, really work on the causes rather than the symptoms.”
While childhood obesity is a particular cause for concern, he stresses health experts are not just dealing with problems of abundance: “We still have people living in hunger.
“If you are poor it is harder to eat healthily because cheaper foods are often higher in fat and sugar and salt. There is clearly a role for education. One of the big things is food and the role of sugar in our foods – especially the role of invisible sugar in fizzy drinks and cereal bars. We need to put sugar on the table again for discussion.”
With other health issues too, behaviour can be modified to produce improved health outcomes – such as not smoking in pregnancy or opting to breastfeed a baby.
Dr Karunanith said: “We need to get our cities and towns healthier by improving access to green spaces, access for cyclists and walking and all that.”
A child’s readiness for school at the age of five is still a key indicator of how that child will grow into adulthood and how successful he or she will be, which means an emphasis on early years’ care will be crucial in years to come.
Dr Karunanithi continued: “There is a huge amount of work currently being done along with the NHS and other public services to develop a five-year forward view for our health and wellbeing and one of the things we need to get right is prevention.”
He is clear the equation for improvement involves policies, politics and the state of the economy. But he also points out that some parts of the county fare far better than others and there are some things Lancashire is really good at. On a positive note, patients’ experience of GPs’ out of hours services is above the national average, as is work to reduce obesity in 10-11 year olds, long-term unemployment and the number of adults with a learning disability who live in stable and appropriate accommodation.
Life expectancy by Lancashire district
Your life expectancy at birth varies according to where you live in Lancashire (data from 2012-14)
Preston: Male 77.4 - Female 81.3
S Ribble: Male 80.2 - Female 83.3
Chorley: Male 79 - Female 82.4
R Valley: Male 81.2 - Female 83.2
Fylde: Male 79.7 - Female 82.6
Wyre: Male 78.7 - Female 82.2
W Lancs: Male: 79.6 - Female 82.8
Lancaster: Male 78.1 - Female 81.9
Burnley: Male 76.1 - Female 80.1
Hyndburn: Male 76.5 - Female 81.1
Pendle: Male 77.8 - Female 81.9